A 40-year-old woman, G3 P2, was scanned at 11 weeks of gestation. We revealed the following findings:

Increased nuchal translucency, NT=6 mm.

Hydrops

Bilateral cleft lip with maxillar prominence

Mesocardia

The maxillar prominence was imitating an image of the proboscis but was located at the level of the mouth not at the level of the eyes. All extremities were of normal appearance, brain anatomy seemed normal as well.

Patient decided for the pregnancy termination based on the ultrasound findings. The karyotype of the fetus was normal. The pathology examination confirmed our ultrasound findings.Images 1,2: Increased nuchal translucency, NT=6 mm.

Images 3-6: Images 3-5 show an axial view of the cleft, the protruding lobe is a maxillar prominence forming the upper lip. Image 6 shows the axial view of the fetal brain with normal choroid plexus and two hemispheres.